The exact cause of chronic fatigue syndrome remains unknown, and the condition is often only diagnosed after other causes for the symptoms have been ruled out. Researchers have now found several hundred specific proteins in the spinal fluid of people with chronic fatigue syndrome that could possibly help scientists develop a diagnostic test for the condition.

Lyme disease itself is positively diagnosed by a positive antibody test, but about 10-15% of patients do not fully recover even after antibiotic treatment. This condition is called neurologic post-treatment Lyme disease (nPTLS), and key symptoms such as severe fatigue and cognitive dysfunction are similar to chronic fatigue syndrome.

Researchers Steven E. Schutzer MD of the University of Medicine and Dentistry of New Jersey and Richard D. Smith PhD of Pacific Northwest National Laboratory analyzed the spinal fluid of three groups of people using mass spectometry. Forty-three were diagnosed with chronic fatigue syndrome (CFS), 25 were treated for Lyme disease but did not fully recover, and 11 were healthy volunteers.

The team identified 738 proteins in the CFS patients that were not found in either post-treatment Lyme disease patients or the group of healthy people. They also identified 692 proteins specific to only those treated for Lyme disease, distinguishing this as a unique condition separate from CFS.

Although much more work needs to be done – Dr. Smith calls it the “tip of our research iceberg” – the discovery opens up the potential for diagnostic tests for both conditions. It may even lead to the development of new or more effective treatments.

The next step, says Dr. Schutzer, is to narrow down the long list of proteins into “candidate biomarkers” for the conditions. Then they will look for some of those same proteins in the blood as it would be difficult to have a diagnostic test based on spinal fluid. “You can’t just go poking everyone in the spine,” commented Suzanne Vernon of the CFIDS Association of America, a CFS patient advocacy group.

Dr. Schutzer is also involved in a separate study examining the possibility that a virus such as XMRV plays a role in chronic fatigue syndrome.